What Does a Performance Measurement System Tell Us About the National Comprehensive Cancer Control Program?

Abstract

Context The National Comprehensive Cancer Control Program (NCCCP) performance measurement system seeks to understand both the processes that funded programs undertake with their respective coalitions to implement the objectives of their cancer plans and outcomes of those efforts. Objective To identify areas of achievement and technical assistance needs of NCCCP awardees. Design Program performance was assessed through surveys completed by program directors on performance indicators in 2009 and 2010 and queries from a web-based management information system in 2011 and 2012. Setting Programs funded by CDC’s NCCCP. Participants 69 programs. Main Outcome Measure(s) The key performance measures assessed were: inclusion of diverse partners and key sectors in cancer coalitions; partners’ involvement in activities; receiving in-kind resources from partners; using evidence-based interventions and data for setting priorities; conducting program evaluation; using community- or organization-level strategies to address cancer control efforts; and demonstrating progress toward achieving health outcomes. Results Most programs reported having active coalitions that represent diverse organizational sectors. Nearly all programs routinely assess the burden of cancer. In-kind resources to implement activities peaked at $64,716 in the second year of a five year funding cycle, and declined in subsequent project years. By year 3, over 70% of programs reported having an evaluation plan. While programs reported that nearly two-thirds of their interventions were evidence-based, some programs implemented non-evidence-based interventions. A majority of programs successfully used at least one community- or organization-level change strategy. However, many programs did not incorporate objectives linked to health outcomes as they reported progress in implementing interventions. Conclusions: While NCCCP programs were strong at building and maintaining infrastructure, some programs may need additional technical assistance to increase the adoption of evidence-based interventions, develop solid and responsive evaluation plans, and better link efforts to population-based measures that demonstrate impact toward reducing the burden of cancer.

Comprehensive Cancer Control Partners’ Use of and Attitudes About Evidence-Based Practices

“…In 2009, NCCCP programs reported that they were working in partnership with more than 6,000 organizations and individuals, including government public health programs (94%), academic (94%) and professional (84%) organizations, cancer survivors (63%), and political leaders (51%) ( 11 ). The programs often leverage the resources of these partners (eg, donated time, financial support, subject matter expertise) to develop and implement interventions in cancer control plans ( 24 ); therefore, CCC partners are crucial to accelerating the adoption of EBPs.…”

“…This percentage is higher than the level of partner involvement in implementing interventions reported by NCCCP program directors in previous studies. Townsend and colleagues evaluated performance measures data reported by NCCCP awardees to CDC as a condition of their funding ( 24 ). In their analysis, 60% of programs reported that their partners had implemented at least one priority strategy from their jurisdiction’s cancer control plan from June 2008 through June 2009.…”

“…Additionally, the Townsend and Rochester studies assessed all interventions reported by programs, not just those that were evidence-based. The differences in findings could also reflect an increase in partner involvement with EBP implementation over time — our survey was conducted more recently, and the performance measures for the current NCCCP project period (2012–2017) place a greater emphasis on collaborating with partners by forming coalition and partner workgroups to implement interventions and coordinate with other chronic disease prevention programs ( 24 ).…”

Combating Cancer Through Public Health Practice in the United States: An In-Depth Look at the National Comprehensive Cancer Control Program

“…Evaluation efforts at the national level in the early years of the program, including the development and fielding of a performance measurement system and cancer plan assessment tool, provided valuable information regarding technical assistance needs and improvements that could be made across all participants [16][17][18]. Results from surveys in 2009 and 2010 showed that a majority of programs had successfully implemented at least one community-or organization-level change strategy; however, not all programs were using only evidence-based interventions, and there were few participants linking their activities to cancer impact [19]. Recognizing that participants needed assistance in these areas, as well as in communicating their efforts, CDC developed an overarching set of strategic priorities to guide the cancer public health practice of all NCCCP participants, regardless of their unique nature and cancer burden [20].…”

Promoting Public Health Through State Cancer Control Plans: A Review of Capacity and Sustainability

“…The Centers for Disease Prevention and Control’s (CDC) National Comprehensive Cancer Control Program (NCCPC) fund 65 awardees (states, territories, Pacific Island jurisdictions, and tribes/tribal organizations) in 69 Comprehensive Cancer Control (CCC) programs to develop and implement CCC plans via CCC coalitions, alliances, or consortia of program stakeholders ( 1 , 2 ). CCC is a process through which communities and partner organizations pool resources to reduce the burden of cancer by reducing cancer risk, finding cancers earlier, improving treatments, increasing the number of people who survive cancer, and improving the quality of life for cancer survivors ( 2 ).…”